Organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Active
Parent organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Other names
Good Samaritan Society - Stillwater
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Authorized official
MS. RAYE NAE NYLANDER (CFO)
(605) 362-3100
Entity
Organization
Contact information
Practice address
1119 OWENS ST N, STILLWATER, MN 55082-4316
(651) 439-7180
(651) 439-4502
Mailing address
PO BOX 5038, SIOUX FALLS, SD 57117-5038
(605) 362-3100
(605) 362-3265
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1026665
PREFERRED ONE EQUALIZATIO
MN
01
—
5A24ST
PMAP BLUE PLUS
MN
01
—
7100094
PMAP MEDICA
MN
01
—
7111789
MEDICA
MN
05
—
722519900
—
MN
01
—
NH0127
UCARE OF MN
MN
Enumeration date
10/26/2005
Last updated
10/25/2021
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